For those of you that are just joining the conversation, we are currently exploring the first process in the Four Processes of MI introduced back in Issue 28. This important starting point for MI is referred to as Engagement and we completed an introduction to what this really means and what helps it to happen last issue. Engagement is much much more than a friendly warm greeting.

Have you ever considered that your ‘job’ may get in the way of you doing good work? In this issue we are looking at how some of our workplace requirements and role expectations can really limit our effectiveness in facilitating behaviour change by blocking client engagement. While taking a look at these challenges I will be exploring some alternative ideas and options to consider. Read on to learn more and have a laugh at Christopher Pyne….

Download Issue 30

Engagement – what does that actually mean?

I wonder if we can take for granted that we understand what ‘to engage’ our client means?

Here are some synonyms of the verb ‘engage’ from Prof Google, to expand and bring this word to life.

Capture ….catch ……….arrest ….seize……… draw ……..attract ……….captivate ……hold….. grip…… engross…… occupy …….absorb

When I first read through this list I was struck by how dynamic these words are. Full of energy, activity, purpose and intent. In our work with a client, engaging is not simply the warm up chat we do before getting to the advice bit.

So what energy or ‘spirit’ are we using when we are engaging our client and what is our intention and purpose?

Read on to find out more, consider some sample questions that embody this purpose and spirit and appreciate some reflections about engagement from colleagues.

Read Issue 29

This issue was in part inspired by a skillful supervisee who came to supervision curious about the impact of working on increasing her reflections in client sessions. Her concerns were more of a hunch than anything concrete; a sense that she may not be holding the purpose of the session clearly enough by engaging in more reflective listening. Was something being lost or diluted in the work via the impact of reflections? Was she at risk of jumping up and down on the spot with the client?

This is such a useful enquiry for our consideration and very timely. I had earmarked the next chapter of issues to commence an exploration of the uniquely directive nature of Motivational Interviewing best encapsulated by the Four Processes of MI. So let’s jump in and find out some more………

Read Issue 28

This issue’s editorial will be wrapping up our ‘Question Series’ commenced back in Issue 21 September 2015. This chapter of issues has presented different views of the power of well considered questions with some enthusiasm. To reinforce our balanced perspective, I will be discussing some cautions in the tale of buoyant questioning as we close the discussion today.

Read Issue 27

Last issue we spent time exploring how questions can be used to seek exceptions to a problem behaviour. Uncovering these exception experiences can reveal overlooked or dismissed resources. Reconnecting our clients to these resources is a powerful intervention that can reinforce our client’s competence and autonomy in the change process. If you’d like to have a quick revision you can access Issue 25 below

Sue Zbornik APD demonstrated a beautiful application of the exception idea at her Appetite Workshops in February. I invited Sue to contribute to this issue and talk a little about this special form of conversation she has with her clients.

Read on to engage with this wonderfully creative application of the ‘Exception Question’

Read Issue 26

So let’s see, in Issue 24 we spent some time thinking about directive questions that pull out our client’s preferred future by eliciting resources, strengths and visions of change. Broadly called ‘Solution Focused’ questions these types of questions are a powerful tool in the kit bag of behaviour change therapists.

Travelling along a similar vein in this issue, I am inviting exploration of questions that look for exceptions to the problem. These types of questions may offer a much more subtle and client focused alternative to imposing a new thought about change. ‘Exception Questions’ may do this by inviting the client to sift through their own experiences with a lens that captures times when the problem has been less of an influence.

Read on to explore more about what this angle of enquiry may have to offer your clients and what it may sound like in session…

Read Issue 25

I’d like to start with a story from a book I am currently enjoying. The story is called ‘The Dog I Feed Most’. It goes like this:

A Native American elder described his inner struggle in this manner: ‘Inside of me there are two dogs. One is mean and evil; the other dog is good. The mean dog fights the good dog all the time’. When his grandson asked him which dog won, the elder replied: ‘The one I feed most’
From: 101 Solution Focused Questions for Anxiety. 2015 Fredrike Bannink

In this issue we are exploring what sort of questions ‘feed the good dog’ in our client? ……questions that elicit information that is of most benefit to our client’s forward movement and successful behaviour change process.

Read Issue 24

Following in the footsteps of the first anniversary edition this issue collates a synopsis of the year’s issues with handy links to each issue’s full editorial. Due to the popularity of the 2014 CPD Quiz a 2015 CPD Quiz has been included in the Purple Pavestone box at the end of the issue summaries. You can buy the quiz to test your knowledge and convert your dedicated reading of Practice Pavestones into assessed CPD hours for your APD renewal…..just around the corner. Please support Pavestones by sending on to APD colleagues who may be looking for great value assessed self-study in this vital area of practice.

Read Issue 23

As mentioned in the wrap up of last issue, this editorial will be exploring in more detail the formulation of open questions and we’ll get some practice in converting closed to open questions using handy word stems.

‘Word Stems’ for Open Questions

Typical choices for getting your questions off to an open start include:

What
Why
How
Where
When
Which
This is in contrast to these typical closed question openers:

‘Do you……’
‘Did you…..’
‘Can you….’
Read the rest of the issue to consider some examples of using these word stems in effective open question formulation

Read Issue 22

For a stunning ‘Captain Obvious’ I’ll start with this definition of a question from The Oxford Dictionary:

a sentence worded or expressed so as to elicit information.

Pretty straight forward. But do we stop to think what kind of information is most beneficial to our client to elicit?

Most health professionals receive lengthy training in assessment and are well rehearsed in asking questions. But what about asking questions with purpose beyond our intake form? If a primary focus of client centered work is to explore our client’s ideas and experience, how can we be aware of the type of questions that can open up exploration and those that can close it down?

To answer this, it can be helpful to consider questions in two basic classes: Closed and Open. Let’s take a quick tour of the difference and pros and cons of each. Download this issue to find out more

Read Issue 21